Clinical Scorecard: Factors Influencing Delayed Surgical Intervention in Pediatric Wilms Tumor Patients at Mulago Hospital: A Mixed-Methods Analysis of Prevalence
At a Glance
Category
Detail
Condition
Wilms Tumor
Key Mechanisms
Delayed surgery impacts survival rates; multimodal treatment strategies include neoadjuvant chemotherapy followed by surgery.
Target Population
Pediatric patients aged 1-18 years diagnosed with Wilms tumor.
Care Setting
Pediatric Haematology and Oncology Unit, Mulago Hospital, Uganda.
Key Highlights
Wilms tumor accounts for 5.9% of childhood cancers.
Survival rates for Wilms tumor in LMICs range from 20% to 50%.
Delayed surgery identified as a primary factor in low survival rates.
Only 30% of patients in Tanzania underwent surgery within one week of completing preoperative chemotherapy.
Factors influencing delays include limited theatre space, workforce shortages, and equipment gaps.
Guideline-Based Recommendations
Diagnosis
Wilms tumor diagnosis confirmed via abdominal CT scan and histology when available.
Management
Neoadjuvant chemotherapy followed by surgery and postoperative chemotherapy/radiotherapy as per SIOP protocol.
Monitoring & Follow-up
Monitor for delays in surgical intervention and assess factors contributing to delays.
Risks
Delayed surgery significantly worsens treatment outcomes and survival rates.
Patient & Prescribing Data
Children aged ≤ 18 years diagnosed with Wilms tumor.
Surgery remains critical for local control and staging despite multimodal treatment strategies.
Clinical Best Practices
Ensure timely surgical intervention to improve survival rates.
Address systemic barriers such as theatre space and workforce shortages.
